眼眶及眶周骨纤维异常增殖症的手术治疗

目的 探索眼眶及眶周骨纤维异常增殖症及其造成畸形的有效安全的手术矫正方法。方法 对眼眶及眼周骨纤维异常增殖症患者10例进行手术治疗,术前根据患者颅部x线片、二维CT及三维CT确定病变的部位、范围及形状。根据不同情况设计不同手术切除和重建方案,分别经头皮冠状切口、口内切口及下睑缘切口入路,对病灶进行完全或部分切除;采用自体颅骨外板或内板、下颌骨外板、Medpor及个体化修复体修复眼眶。结果 10例患者中,完全切除4例,不完全切除6例。自体颅骨内板修复2例,Medpor修复2例,下颌骨外板修复1例,钛网及个体化修复体修复4例,效果均满意。结论在充分做好术前设计和严格防止并发症发生的情况下,手术治疗眼眶骨纤维异常增殖症可取得满意的效果。（中华眼科杂志,2004,40：800-803)

Surgical treatment of orbital and periorbital fibrous dysplasia

Objective To explore the surgical approaches to obtain good aesthetic and functional results in the management of orbital and periorbital fibrous dysplasia and related deformities.Methods Ten cases of orbital and periorbital fibrous dysplasia were treated surgically. The location, extension and shape of the lesions were identified based on X-ray examination and two and three dimensions CT examinations preoperatively. According to the type of the lesion, different approaches were used to excise the lesion and to reconstructe the orbit. The lesions were radically or partially excised through bicoronal, intraoral and subciliary approach; the orbit was reconstructed with autogenous outer or inner table of calvarium, outer table of mandible, Medpor and prefabricated individual titanic implants.Results In 10 cases treated surgically, radical excision was employed in 4 cases and partial excision in 6 cases. Autogenous inner table of calvarium was used in 2 cases, Medpor in 2 cases, outer table of mandible in 1 case, and titanic meshwork and prefabricated individual titanic implants in 4 cases to reconstruct the orbit. After the treatment, all patients obtained satisfactory aesthetic and functional results. Conclusions Carefully planed surgical approaches with methods for preventing the complications can be used for the treatment of orbital and periorbital fibrous dysplasia and obtaining satisfactory aesthetic and functional results.